Healthcare Provider Details

I. General information

NPI: 1104133917
Provider Name (Legal Business Name): VICTOR S LAMBERTO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2010
Last Update Date: 08/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 N OCEAN BLVD
BOCA RATON FL
33431-5364
US

IV. Provider business mailing address

4301 N OCEAN BLVD
BOCA RATON FL
33431-5364
US

V. Phone/Fax

Practice location:
  • Phone: 646-505-9964
  • Fax:
Mailing address:
  • Phone: 646-505-9964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number098719
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME111301
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: